Oscillating positive expiratory pressure device

ABSTRACT

An oscillating positive expiratory pressure apparatus having a housing defining a chamber, a chamber inlet, a chamber outlet, a deformable restrictor member positioned in an exhalation flow path between the chamber inlet and the chamber outlet, and an oscillation member disposed within the chamber. The deformable restrictor member and the oscillation member are moveable between an engaged position, where the oscillation member is in contact with the deformable restrictor member and an disengaged position, where the oscillation member is not in contact with the deformable restrictor member. The deformable restrictor member and the oscillation member move from the engaged position to the disengaged position in response to a first exhalation pressure at the chamber inlet, and move from the disengaged position to an engaged position in response to a second exhalation pressure at the chamber inlet.

RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.13/674,340, filed on Nov. 12, 2012, pending, which claims the benefit ofU.S. application Ser. No. 12/607,496, filed on Oct. 28, 2009, issued asU.S. Pat. No. 8,327,849, which claims the benefit of U.S. ProvisionalApplication No. 61/109,075, filed on Oct. 28, 2008, abandoned, all ofwhich are incorporated herein by reference.

TECHNICAL FIELD

The present disclosure relates to an expiratory treatment device, and inparticular, to an oscillating positive expiratory pressure (“OPEP”)device.

BACKGROUND

Each day, humans may produce upwards of 30 milliliters of sputum, whichis a type of bronchial secretion. Normally, an effective cough issufficient to loosen secretions and clear them from the body's airways.However, for individuals suffering from more significant bronchialobstructions, such as collapsed airways, a single cough may beinsufficient to clear the obstructions.

OPEP therapy represents an effective bronchial hygiene technique for theremoval of bronchial secretions in the human body and is an importantaspect in the treatment and continuing care of patients with bronchialobstructions, such as those suffering from chronic obstructive lungdisease. It is believed that OPEP therapy, or the oscillation ofexhalation pressure at the mouth during exhalation, effectivelytransmits an oscillating back pressure to the lungs, thereby splittingopen obstructed airways and loosening the secretions contributing tobronchial obstructions.

OPEP therapy is an attractive form of treatment because it can be easilytaught to most hospitalized patients, and such patients can assumeresponsibility for the administration of OPEP therapy throughout theirhospitalization and also once they have returned home. To that end, anumber of portable OPEP devices have been developed.

BRIEF SUMMARY

A portable OPEP device and a method of performing OPEP therapy isdescribed herein. In one aspect, a portable OPEP device includes ahousing defining a chamber, a chamber inlet configured to receiveexhaled air into the chamber, a chamber outlet configured to permitexhaled air to exit the chamber, a deformable restrictor memberpositioned in an exhalation flow path between the chamber inlet and thechamber outlet, and an oscillation member disposed within the chamber.The deformable restrictor member and the oscillation member are moveablerelative to one another between an engaged position, where theoscillation member is in contact with the deformable restrictor memberand a disengaged position, where the oscillation member is not incontact with the deformable restrictor member. The deformable restrictormember and the oscillation member are also configured to move from theengaged position to the disengaged position in response to a firstexhalation pressure at the chamber inlet, and move from the disengagedposition to an engaged position in response to a second exhalationpressure at the chamber inlet. The first exhalation pressure is greaterthan the second exhalation pressure.

In another aspect, the deformable restrictor member deforms in responseto an intermediate exhalation pressure at the chamber inlet, and returnsto a natural shape in response to the first exhalation pressure at thechamber inlet.

In another aspect, the OPEP device has a biasing member positioned tobias the deformable restrictor member and the oscillation member to theengaged position. The biasing member maybe a spring. Alternatively, thebiasing member may have at least one pair of magnets, wherein a firstmagnet of the at least one pair of magnets is connected to theoscillation member and a second magnet of the at least one pair ofmagnets is connected to the housing. The position of the biasing membermay also be selectively moveable to adjust the amount of bias

In yet another aspect, the OPEP device includes a glide surfaceextending from the housing into the chamber, such that the glide surfaceis in sliding contact about the oscillation member, and movement of theoscillation member is substantially limited to reciprocal movement aboutan axis of the oscillation member.

In another aspect, the oscillation member includes at least one channeladapted so that the exhalation flow path is not completely restrictedwhen the deformable restrictor member and the oscillation member are inthe engaged positioned.

In another aspect, the OPEP device includes a mouthpiece connected tothe housing that is in fluid communication with the chamber inlet. Themouthpiece may have a cross-sectional area greater than across-sectional area of the chamber inlet.

In yet another aspect, the housing has a first portion and a secondportion, with the second portion being removably connected to the firstportion.

In another aspect, the OPEP device includes a respiratory portal forreceiving an aerosol medicament. Additionally, the oscillation membermay comprise a one-way valve configured to permit the aerosol medicamentto enter the chamber through the respiratory portal, the respiratoryportal being in fluid communication with the chamber inlet when theone-way valve is open.

In another aspect, a method of performing oscillating positiveexpiratory pressure therapy is provided. The method includes passing aflow of exhaled air along an exhalation flow path defined between aninlet and an outlet of a chamber in an oscillating positive expiratorypressure device. The method also includes restricting the flow ofexhaled air by maintaining a deformable restrictor member and anoscillation member disposed within the chamber in an engaged position,where the oscillation member is in contact with the deformablerestrictor member, until a first exhalation pressure is reached at achamber inlet. The method further includes unrestricting the flow ofexhaled air by moving the deformable restrictor member and theoscillation member to a disengaged position, where the oscillationmember is not in contact with the deformable restrictor member, until asecond exhalation pressure is reached at the chamber inlet. The methodalso includes returning the deformable restrictor member and theoscillation member to the engaged position with a biasing force when thesecond exhalation pressure is reached at the chamber inlet. The firstexhalation pressure may be greater than the second exhalation pressure.Finally, the method may also include deforming the deformable restrictormember in response to an intermediate exhalation pressure at the chamberinlet, and returning the deformable restrictor member to a natural shapein response to the first exhalation pressure at the chamber inlet.

In another embodiment, a system for providing oscillating positiveexpiratory pressure therapy in combination with aerosol therapy isprovided. The system includes an oscillating positive expiratorypressure apparatus having a housing defining a chamber, a chamber inletconfigured to receive exhaled air into the chamber, and a chamber outletconfigured to permit exhaled air to exit the chamber. The oscillatingpositive expiratory pressure apparatus also has an exhalation flow pathdefined between the chamber inlet and the chamber outlet, and anoscillation member disposed within the chamber and configured tooperatively restrict a flow of exhaled air along the exhalation flowpath. The oscillation member is moveable relative to the flow pathbetween a restrictive position, where the flow of exhaled air issubstantially restricted and an unrestrictive position, where the flowof exhaled air is substantially unrestricted. The oscillating positiveexpiratory pressure apparatus may also have a respiratory portal forreceiving an aerosol medicament. The respiratory portal maybe in fluidcommunication with the chamber inlet. The system also includes anaerosol therapy apparatus removably connected to the respiratory portalof the oscillating positive expiratory pressure apparatus. The aerosoltherapy apparatus includes an aerosol housing having an aerosol chamberfor holding an aerosol medicament, and an aerosol outlet communicatingwith the aerosol chamber for permitting the aerosol medicament to bewithdrawn from the aerosol chamber.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front perspective view of a first embodiment of an OPEPdevice;

FIG. 2 is a side perspective view of the embodiment of FIG. 1;

FIG. 3 is a cross-sectional side view of the embodiment of FIG. 1,showing a deformable restrictor member and an oscillation member in anengaged position;

FIG. 4 is a cross-sectional perspective view of an inlet insert shown inthe embodiment of FIG. 1;

FIG. 5 is a cross-sectional perspective view of a deformable restrictormember shown in the embodiment of FIG. 1;

FIG. 6 is a front perspective view of an oscillation member shown in theembodiment of FIG. 3;

FIG. 7 is a rear perspective view of the oscillation member shown in theembodiment of FIG. 3;

FIG. 8 is a cross-sectional side view of a second embodiment of an OPEPdevice, showing a deformable restrictor member and an oscillation memberin an engaged position;

FIG. 9 is a cross-sectional side view of the embodiment of FIG. 8,showing the flow of air upon a user's inhalation;

FIG. 10 is a cross-sectional side view of the embodiment of FIG. 8,showing the flow of air upon a user's exhalation;

FIG. 11 is a cross-sectional side view of an OPEP device connected to anebulizer, showing the flow of an aerosol medicament upon a user'sinhalation;

FIG. 12 is a cross-sectional side view of the OPEP device and nebulizerof FIG. 11, showing the flow of air upon a user's exhalation; and,

FIG. 13 is a cross-sectional rear perspective view of a third embodimentof an OPEP device having a biasing member comprised of at least one pairof opposing magnets.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

OPEP therapy is very effective within a specific range of operatingconditions. For example, an adult human may have an exhalation flow rateranging from 10 to 60 liters per minute, and may maintain a staticexhalation pressure in the range of 10 to 20 cm H₂O. Within theseparameters, OPEP therapy is believed to be most effective when changesin the exhalation pressure range from 5 to 20 cm H₂O oscillating at afrequency of 10 to 40 Hz. In contrast, an infant may have a much lowerexhalation flow rate, and may maintain a lower static exhalationpressure, thereby altering the operating conditions most effective forOPEP therapy. As described below, the present invention is configurableso that ideal operating conditions may be selected and maintained.

Referring to FIG. 1, a first embodiment of an assembled OPEP device 100is shown. The OPEP device 100 comprises a housing 102 having a frontportion 104 and a rear portion 106 which together defines a chamber 108(see FIG. 3). The housing 102 may be constructed of any durablematerial, such as a plastic or a metal. The OPEP device 100 shown inFIG. 1 is substantially spherical in shape, which provides for an easygrasp of the OPEP device 100 in the hands of a user, as well asportability. It should be appreciated, however, that the OPEP device 100could be any shape, so long as it defines a chamber 108 capable ofhousing the necessary components, as described herein. Preferably, thehousing 102 is openable so the chamber 108 may be accessed for cleaningand replacing components contained therein. As shown, the front portion104 and the rear portion 106 of the housing 102 are removably connectedalong a joint 110, such as by a snap fit or a threaded screw connection.

The OPEP device 112 also includes a mouthpiece 112 which may either beformed as an integral part of the housing 102 or removably attached tothe housing 102. Although the mouthpiece 112 is shown as beingcylindrical in shape, the mouthpiece 112 could be any number ofalternative sizes or shapes to accommodate various users of the OPEPdevice 100, such as children or adults. A chamber inlet 114 positionedwithin the mouthpiece 112 is configured to receive exhaled air into thechamber 108. In view of the description below, it should be apparentthat the cross sectional area of the chamber inlet 114 is an importantvariable affecting the exhalation pressure generated at the mouth of auser, and maybe modified or selectively replaced according to thedesired operating conditions.

A side perspective view of the OPEP device 100 is shown in FIG. 2. TheOPEP device 100 further comprises at least one chamber outlet 116configured to permit exhaled air to exit the chamber 108. The at leastone chamber outlet 116 may comprise any number of apertures, having anyshape or size. Furthermore, the at least one chamber outlet 116 maybelocated elsewhere on the housing 102. The OPEP device 100 may alsoinclude a grate 117 to prevent unwanted objects from entering housing102.

Referring to FIG. 3, a cross-sectional side view of the OPEP device 100shows the internal components of the OPEP device 100. The minimal numberof components contained in the OPEP device 100, and its relativelysimple operation, make the OPEP device 100 particularly suitable forsingle patient use. In general, the housing 102 of the OPEP device 100encloses an inlet insert 118, a deformable restrictor member 120, anoscillation member 122, a coil spring 124, and a glide surface 126. Asexplained below, the various alternatives for each of the inlet insert118, the deformable restrictor member 120, the oscillation member 122,and the coil spring 124 provide of a highly configurable OPEP device100.

A cross-sectional perspective view of the inlet insert 118 is shown inFIG. 4. The inlet insert 118 is removably connectable to the housing 102and/or mouthpiece 112 of the OPEP device 100, and includes the chamberinlet 114. The chamber inlet 114 may be a single narrow aperture, oralternatively, may comprise any number of apertures having any size orshape. Because the inlet insert 118 is removably connectable to the OPEPdevice 100, a user may select an inlet insert 118 having the appropriatesized chamber inlet 114 for the prescribed OPEP therapy. It isimportant, however, that the mouthpiece 112 have a cross-sectional areagreater than the cross-sectional area of the chamber inlet 114.

The inlet insert 118 is configured to be snap or compression fit withinthe front portion 104 of the housing 102, which maybe accomplished whilethe front portion 104 and the rear portion 106 are detached. The inletinsert 118 includes an annular recess 128 for receiving a correspondingannular protrusion 130, which may be located on a rim 131 connected toeither the mouthpiece 112 or the housing 102, as shown in FIG. 4.Furthermore, the inlet insert 118 is shaped to fit within thespherically shaped OPEP device 100; however, the inlet insert 118 couldbe modified to fit within any other shaped OPEP device. Alternatively,the inlet insert 118 and the chamber inlet 114 may be formed as anintegral part of the housing 102 or the mouthpiece 112. The inlet insert118 further includes an annular mounting surface 132 for supporting thedeformable restrictor member 120, as described below.

Referring to FIG. 5, a cross-sectional perspective view of thedeformable restrictor member 120 is shown. The deformable restrictormember 120 operates as a regulator of the exhalation pressure at thechamber inlet 114. The deformable restrictor member 120 maybeconstructed of an elastic material, preferably having an elasticity ofat least 40 durometers (A scale). Like the inlet insert 118, thedeformable restrictor member 120 maybe any number of shapes, but isshown in FIG. 5 as being circular to fit within the spherically shapedOPEP device 100.

The deformable restrictor member 120 generally includes an upper portion134, a lower portion 136, and a reinforcing band 138 of elasticmaterial. As shown in FIG. 3, the upper portion 134 is configured formounting the deformable restrictor member 120 on the mounting surface132 and about the rim 131, as explained above. When the front portion104 and the rear portion 106 of the housing 102 are detached, the upperportion 134 of the deformable restrictor member 120 is mountable aboutthe rim 131 of the inlet insert 118, and the inlet insert 118 maybesnapped into place within the housing 102. Once the inlet insert 118 isconnected to the housing 102, the deformable restrictor member 120 isretained by the rim 131, the mounting surface 132, and the front portion104 of the housing 102. Alternatively, the housing 102 or the mouthpiece112 may be configured to provide the rim 131 and the mounting surface132 for mounting and retaining the deformable restrictor member 120.

The deformable restrictor member 120, and in particular, the lowerportion 136, is configured to deform as the exhalation pressure at thechamber inlet 114 increases. Preferably, the lower portion 136 of thedeformable restrictor member 120 should be curved inward so that, as thedeformable restrictor member 120 deforms, the lower portion 136 expandsin a direction away from the upper portion 134. To improve theelasticity and rigidness of the deformable restrictor member 120, areinforcing band 138 of elastic material maybe added to the deformablerestrictor member 120. Depending on the shape of the deformablerestrictor member 120 and the desired elasticity, the reinforcing band138 maybe omitted or located elsewhere on the deformable restrictormember 120.

Referring to FIG. 6, a front perspective view of an oscillation member122 is shown. In general, the oscillation member 122 includes a contactsurface 140 connected to the end of a post 142. The contact surface 140is configured to engage the lower portion 136 of the deformablerestrictor member 120. As shown in FIGS. 3 and 6, the contact surface140 maybe hemispherically shaped to fit within a correspondingly shapedportion of the inlet insert 118, or a correspondingly shaped portion ofthe housing 102 or mouthpiece 112 if the inlet insert 118 is omitted.Alternatively, the contact surface 140 maybe substantially flat.

The contact surface 140 shown in FIG. 6 includes at least one channel143 which traverses a portion of the contact surface 140 where thedeformable restrictor member 120 and the oscillation member 122 engageone another. In this embodiment, the channels 143 are sized such that anair passage from the chamber inlet 114 to the chamber outlet 116 ismaintained during both inhalation and exhalation via the space definedby the restrictor member 120 and the channels 143. This air passage, orcollection of air passages, is sized to prevent complete restriction ofair flow but selected to allow sufficient build-up of pressure toprovide oscillating pressure upon patient exhalation.

Although the contact surface 140 is shown in FIG. 6 as having sevenseparate channels 143, the contact surface 140 could include any numberof channels 143. Furthermore, the one or more channels 143 may have avariety of sizes, depending upon the desired restriction of exhaled airreceived from the user. Alternatively, the contact surface 140 may befabricated without any channels 140. Because the oscillation member 120is removably enclosed within the housing 102 of the OPEP device 100, auser may select an oscillation member 120 having the appropriate shape,size, or number of channels for the prescribed OPEP therapy.

A rear perspective view of the oscillation member 122 is shown in FIG.7. The post 142 is configured for positioning about the glide surface126, as shown in FIG. 3, so that the post 142 is in sliding contact withthe glide surface 126. When the post 142 is positioned about the glidesurface 126, the oscillation member 122 is substantially limited toreciprocal movement about the central axis of the oscillation member122. As shown in FIGS. 3 and 7, the glide surface 126 and the post 142are shaped as hollow cylinders, and the post 142 is sized to fit withinthe glide surface 126. However, the glide surface 126 and the post 142may have any shape, and the glide surface 126 maybe alternatively sizedto fit within the post 142. The oscillation member 122 also includes askirt 144 for aligning a biasing member, such as the coil spring 124,about the oscillation member 122 when the OPEP device 100 is assembled.

Referring to FIG. 3, the coil spring 124 is positioned to extend fromthe housing 102 and contact a lower surface 146 of the oscillationmember 122. The coil spring 124 is positioned to bias the oscillationmember 122 into engagement with the deformable restrictor member 120.Similar to the deformable restrictor member 120 and the oscillationmember 122, the coil spring 124 maybe selectively replaced with othersprings have a different rigidity or number of coils to achieve thedesired operating conditions for the prescribed OPEP treatment.

To administer OPEP therapy using the OPEP device 100 descried above, auser begins by exhaling into the mouthpiece 112. In doing so, anexhalation flow path 148 is defined between the chamber inlet 114 andthe at least one chamber outlet 116. The exhalation pressure at thechamber inlet 114 represents a function of the flow of exhaled airpermitted to traverse the exhalation flow path 148 and exit the OPEPdevice 100 through the chamber outlet 116. As the exhalation pressure atthe chamber inlet 114 changes, an equal back pressure is effectivelytransmitted to the respiratory system of the user.

As shown in FIG. 3, prior to using the OPEP device 100, the oscillationmember 122 is biased to an engaged position, where the deformablerestrictor member 120 is in contact with the oscillation member 122. Inthe engaged position, the exhalation flow path 148 is substantiallyrestricted by the deformable restrictor member 120 and the oscillationmember 122. As a user exhales into the OPEP device 100, an initialexhalation pressure at the chamber inlet 114 begins to increase, as onlya fraction of the exhaled air is permitted to flow along the exhalationflow path 148 through the at least one channel 142 on the oscillationmember 122. As the exhalation pressure increases at the chamber inlet114 to an intermediate pressure, the deformable restrictor member 120begins to expand under the force of the increased pressure. As thedeformable restrictor member 120 expands, the lower portion 136 moves inan outward direction, toward the oscillation member 122. In the engagedposition, however, the outward movement of the lower portion 136 isresisted by the oscillation member 122, which is biased against thedeformable restrictor member 120 by the coil spring 124. As theexhalation pressure continues to increase, the deformable restrictormember 120 continues to deform until a maximum point of expansion isobtained. When the deformable restrictor member 120 obtains its maximumexpansion, the exhalation pressure is also at a maximum pressure.

At the maximum point of expansion, the increasing exhalation pressurecauses the deformable restrictor member 120 to quickly retract,ultimately returning to its natural shape. As the deformable restrictormember 120 retracts, the deformable restrictor member 120 and theoscillation member 122 move to a disengaged position, where thedeformable restrictor member 120 is not in contact with the oscillationmember 122. At that time, exhaled air is permitted to flow substantiallyunrestricted along the exhalation flow path 148 from the chamber inlet114 to the chamber outlet 116. Because the retraction of the deformablerestrictor member 120 is quicker than the movement of the oscillationmember 122 under the biasing force of the coil spring 124, thedeformable restrictor member 120 and the oscillation member 122 remainin the disengaged position for a short period of time, during which theexhalation pressure at the chamber inlet 114 decreases. Depending onmultiple variables, including the elasticity of the deformablerestrictor member 120, the biasing force of the coil spring 124, and theexhalation flow rate, the deformable restrictor member 120 and theoscillation member 122 may remain in the disengaged position for only afraction of a second.

After the deformable restrictor member 120 returns to its natural shape,the oscillation member 122, under the biasing force of the coil spring124, moves back into an engaged position with the deformable restrictormember 120. Then, as a user continues to exhale, the exhalation pressureat the chamber inlet 114 begins to increase, and the cycle describedabove is repeated. In this way, the exhalation pressure at the chamberinlet 114 oscillates between a minimum and a maximum so long as a usercontinues to exhale into the OPEP device 100. This oscillating pressureis effectively transmitted back to the respiratory system of the user toprovide OPEP therapy.

A cross-sectional side view of a second embodiment of an OPEP device 200is shown in FIG. 8. Like the OPEP device 100, a housing 202 of the OPEPdevice 200 encloses a deformable restrictor member 220, an oscillationmember 222, a coil spring 224, and a glide surface 226. The OPEP device200 also includes a mouthpiece 212, a chamber inlet 214, a chamberoutlet 216, and has an exhalation flow path 248 defined therebetween.

The OPEP device 200 further comprises an adjustment plate 254 forselectively moving an end of a biasing member, such as the coil spring224, to adjust the amount of bias. The adjustment plate 254 is connectedto at least one thumb screw 256 extending from the adjustment plate 254to a location outside the housing 202. In this way, a user may rotatethe at least one thumb screw 256 in one direction to move both theadjustment plate 254 and an end of the coil spring 224 toward theoscillation member 222, thereby increasing the bias. A user may rotatethe at least one thumb screw 256 the opposite direction to decrease thebias. By changing the amount of bias, a user may selectively increase ordecrease the resistance the oscillation member 222 applies against thedeformable restrictor member 222 while in the engaged position. A changein the bias also changes the rate at which the oscillation member 222moves from the engaged position to the disengaged position, and back tothe engaged position, during the administration of OPEP therapy.

The OPEP device 200 shown in FIG. 8 further comprises a respiratoryportal 250 and a one-way valve 252 positioned on the oscillation member222. The oscillation member 222 shown in FIG. 8 omits the at least onechannel and has a substantially flat contact surface 240 to accommodatethe one-way valve 252. The one-way valve 252 is configured to open as auser inhales, and permit air to enter the chamber 208 from therespiratory portal 250, as shown in FIG. 9. In contrast, the one-wayvalve 252 is closed during exhalation, as seen at one point during theadministration of OPEP therapy in FIG. 10, when the deformablerestrictor member 220 and the oscillation member 222 are in thedisengaged position.

Referring to FIG. 11, the respiratory portal 250 of the OPEP device 200is also configured to receive an aerosol outlet 260 of a nebulizer 258.The nebulizer 258 maybe removably connected to the OPEP device 200 byany suitable means for the combined administration of OPEP and aerosoltherapies. Any of a number of commercially available nebulizers may beused with the OPEP device 200. One suitable nebulizer is theAeroEclipse® II breath actuated nebulizer available from Trudell MedicalInternational of London, Canada. Descriptions of suitable nebulizers maybe found in U.S. Pat. No. 5,823,179, the entirety of which is herebyincorporated by reference herein.

In this configuration, a user receives aerosol therapy upon inhalation.As seen in FIG. 11, when a user inhales, the one-way valve 252 opens,and an aerosol medicament is drawn from the aerosol output 260, throughthe respiratory 250 portal and the chamber 208, and into the respiratorysystem of the user. In contrast, OPEP therapy is delivered uponexhalation. As seen in FIG. 12, when a user exhales, the one-way valve252 closes, the aerosol medicament is contained within the respiratoryportal 250, and the OPEP device 200 is able to deliver OPEP therapy inaccordance with the method described above.

A cross-sectional perspective view of a third embodiment of an OPEPdevice 300 is shown in FIG. 13. In general, a housing 302 of the OPEPdevice 300 encloses a deformable restrictor member 320, an oscillationmember 322 having a one-way valve 352, a glide surface 326, and anadjustment plate 354. The OPEP device 300 also includes a mouthpiece312, a chamber inlet 314, a chamber outlet 316, and a respiratory portal350.

The OPEP device 300 is different from the OPEP device 200 in that itincludes a biasing member comprised of at least one pair of magnets 362.For each pair of the at least one pair of magnets 362, one magnet ispositioned on the oscillation member 322 and another magnet ispositioned on the adjustment plate 354. The magnets in each pair haveopposing polarities. As such, the oscillation member 322 is biased bythe at least one pair of magnets 362 into the engaged position with thedeformable restrictor member 320.

During the administration of OPEP therapy, the at least one pair ofmagnets 362 functions in the same manner as the coil spring, asdiscussed above. Specifically, as a user exhales into the OPEP device300 and the deformable restrictor member 320 expands, the at least onepair of magnets 362 resist the movement of oscillation member 322. Afterthe deformable restrictor member 320 has reached its maximum point ofexpansion and quickly returned to its natural shape, the at least onepair of magnets 362 bias the oscillation member 322 from the disengagedposition back to the engaged position. Furthermore, like the OPEP device200, the amount of bias supplied by the at least one pair of magnets 362may be adjusted by rotating the at least one thumb screw 356, therebymoving the adjustment plate 354 and the magnets positioned thereoncloser to the magnets positioned on the oscillation member 322.

The foregoing description of the inventions has been presented forpurposes of illustration and description, and is not intended to beexhaustive or to limit the inventions to the precise forms disclosed. Itwill be apparent to those skilled in the art that the present inventionsare susceptible of many variations and modifications coming within thescope of the following claims.

What is claimed is:
 1. An oscillating positive expiratory pressureapparatus comprising: a housing defining a chamber, a chamber inletconfigured to receive exhaled air into the chamber; a chamber outletconfigured to permit exhaled air to exit the chamber; an exhalation flowpath defined between the chamber inlet and the chamber outlet; anelastic lip surrounding an opening through which the exhalation flowpath passes; and, a contact surface positioned adjacent to and inengagement with the elastic lip; wherein the elastic lip is resilientlyexpandable in response to an increase in exhalation pressure at thechamber inlet from an engaged position, where the flow of air throughthe opening is restricted, to a disengaged position, where the flow ofair through the opening is less restricted.
 2. The oscillating positiveexpiratory pressure apparatus of claim 1, wherein the elastic lip isresiliently contactable from the disengaged position to the engagedposition in response to a decrease in exhalation pressure at the chamberinlet.
 3. The oscillating positive expiratory pressure apparatus ofclaim 2, wherein the elastic lip is configured to repeatedly expand andcontract between the engaged position and the disengaged position duringa flow of air along the exhalation flow path.
 4. The oscillatingpositive expiratory pressure apparatus of claim 1, wherein the contactsurface is configured to move with the elastic lip while the lip is inthe engaged position.
 5. The oscillating positive expiratory pressureapparatus of claim 4 further comprising a biasing member configured tobias the contact surface in to the engaged position with the elasticlip.
 6. The oscillating positive expiratory pressure apparatus of claim5, wherein the biasing member comprises a spring.
 7. The oscillatingpositive expiratory pressure apparatus of claim 5, wherein the biasingmember comprises at least one pair of magnets, a first magnet of the atleast one pair of magnets being connected to the contact surface and asecond magnet of the at least one pair of magnets being connected to thehousing.
 8. The oscillating positive expiratory pressure apparatus ofclaim 5, wherein the position of the biasing member is selectivelymoveable to adjust the amount of bias.
 9. The oscillating positiveexpiratory pressure apparatus of claim 4, wherein the contact surface ispositioned on an oscillation member mounted about a glide surface, theglide surface extending from the housing into the chamber such thatmovement of the contact surface is substantially limited to reciprocalmovement.
 10. The oscillating positive expiratory pressure apparatus ofclaim 1, wherein the contact surface further comprises at least onechannel adapted so that the exhalation flow path is not completelyrestricted when the elastic lip and the contact surface are in theengaged positioned.
 11. The oscillating positive expiratory pressureapparatus of claim 1 further comprising a mouthpiece connected to thehousing and in fluid communication with the chamber inlet.
 12. Theoscillating positive expiratory pressure apparatus of claim 11, whereinthe mouthpiece has a cross-sectional area greater than a cross-sectionalarea of the chamber inlet.
 13. The oscillating positive expiratorypressure apparatus of claim 1, wherein the housing comprises a firstportion and a second portion, the second portion being removablyconnected to the first portion.
 14. The oscillating positive expiratorypressure apparatus of claim 1 further comprising a respiratory portalfor receiving an aerosol medicament into the chamber.
 15. Theoscillating positive expiratory pressure apparatus of claim 14, whereinthe contact surface further comprises a one-way valve configured topermit the aerosol medicament to enter the chamber through therespiratory portal, the respiratory portal being in fluid communicationwith the chamber inlet when the one-way valve is open.